For health services to be efficient, and relevant for patients with chronic disease, patients must play an active role in management. Past studies have demonstrated that English-speaking patients can benefit from chronic disease self-management education. Initial results suggest that these same benefits occur for Spanish-speaking arthritis patients. This is especially important because Hispanics are the fastest growing population in the United States and, at the same time, carry a disproportionate burden of chronic disease. In addition, they often encounter limited access to health care and health education due to certain economic, language and cultural barriers. The proposed project will address these issues by: 1. Developing and implementing an experimental community-based Spanish language health education program for self-management for patients with three chronic diseases (coronary artery disease, chronic obstructive pulmonary disease and type II diabetes). Patients with different conditions will attend the same program together as has been successful with English-speaking patients. 2. Conduct a 4-month randomized trial to determine the impact of the program on: a.) the subsequent use of self-management practices; b.) self-efficacy to manage disease-related problems and symptoms; c.) the physical and emotional health status of the participants; and, d.) the health service utilization of the participants. 3. Conduct a 1-year longitudinal study to determine the long-term effectiveness of the program. 4. Conduct exploratory studies to 1) determine if the program is more beneficial for some subgroups, and 2) to explore the mechanisms by which health status improves.